Individual
DR. JOHN C DE TOLEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3601 4TH ST, LUBBOCK, TX 79430-8321
(806) 743-2391
(806) 743-5687
Mailing address
3601 4TH ST, LUBBOCK, TX 79430-8321
(806) 743-2391
(806) 743-5687
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
N9361
TX
2084N0400X
Neurology Physician
Primary
N9361
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
144PN
BCBS
NC
05
—
1477570810
—
VA
01
—
198275
MEDCOST
NC
05
—
202479601
—
TX
05
—
3791921-00
—
FL
05
—
3810009737
—
WV
01
—
4122695
AETNA
NC
05
—
5907931
—
NC
01
—
809210
PARTNERS
NC
05
—
Q0024N
—
SC
Enumeration date
07/15/2006
Last updated
03/20/2024
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